Technology Enhanced Substance Use and HIV Service Navigation for Sexual and Gender Minority Young Adults Surveilled by the Carceral System

技术增强了监狱系统监控的性少数群体年轻人的药物使用和艾滋病毒服务导航

• 批准号: 10771060
• 负责人: Emily F Dauria
• 金额: $ 10万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10771060
• 关键词: AIDS prevention; Address; Adherence; Administrative Supplement; Adult; Affect; Award; Awareness; Characteristics; Clinical Trials; Community of Practice; Complex; Consolidated Framework for Implementation Research; Continuity of Patient Care; Enhancement Technology; Feedback; Focus Groups; Funding; Future; Goals; HIV; HIV Seropositivity; Healthcare; Heterosexuals; Imprisonment; Improve Access; Individual; Inequity; Intervention; Intervention Studies; Interview; Jail; Lead; Link; Literature; Measures; Mental Health; Modeling; Movement; Outcome; Parents; Participant; Patient Self-Report; Persons; Population; Prevention strategy; Prisons; Process; Publishing; Research; Risk; Services; Sexual Health; Sexual and Gender Minorities; Structure; Subgroup; Substance Use Disorder; System; Technology; Testing; Time; Trust; United States; Work; acceptability and feasibility; barrier to care; behavioral health; behavioral health intervention; cisgender; disorder prevention; disparity reduction; eHealth; effective intervention; efficacy testing; experience; gender minority; gender minority group; health care availability; high risk; implementation process; improved; informant; innovation; intervention delivery; meetings; minority stress; minority stressor; multidisciplinary; peer; pilot test; pre-exposure prophylaxis; prevention service; preventive intervention; racism; satisfaction; service intervention; sexual minority; social; social stigma; study population; substance use; substance use treatment; theories; treatment services; uptake; young adult

Project Summary/Abstract There is a strong scientific premise for the study of integrated substance use disorders (SUDs) and HIV- prevention interventions for individuals surveilled by the carceral system (CS). SUDs lead to increased rates of CS involvement as well as increased risk for HIV-acquisition. Estimates of the proportion of the CS-involved population with a SUD reach 72%, and ~150,000 persons with HIV pass through a detention facility annually. Individuals with a self-reported sexual or gender minority (SGM) identity are overrepresented in the CS, and experience well established HIV and substance use inequities. Although pre-exposure prophylaxis (PrEP) is a proven effective intervention for HIV-prevention, its maximal impact depends on uptake, and adherence among those at high risk. To date, few published studies have examined substance use treatment and HIV-prevention uptake among CS-involved populations, including among SGM adults. Peer-led navigation interventions have demonstrated efficacy in building trust and reducing barriers to healthcare engagement, and hold strong potential to address multiple, and complex barriers to treatment and HIV-prevention linkage for SGMYA surveilled by the CS. eHealth approaches to SUD and HIV prevention also hold promise because they improve access to effective intervention services, particularly for SGM groups and younger people. As a multidisciplinary team with expertise in behavioral health (substance use, mental health, HIV prevention), SGM and CS involved adults, and eHealth enhanced and navigator-led behavioral health interventions, we propose to address notable gaps in the literature by expanding the aims of our parent award to examine the feasibility and acceptability of an eHealth enhanced navigator-led SUD and HIV-prevention referral and linkage intervention for SGMYA surveilled by the CS. Study aims are to: 1) Tailor the content and structure of an eHealth technology-supported navigation intervention for substance use treatment and HIV-prevention (PrEP) services to the unique needs of SGMYA (18 to 29 years) surveilled by the CS; 2) Refine and test the tailored eHealth enhanced, navigator-led substance use treatment and HIV prevention (PrEP) intervention for SGMYA surveilled by the CS, for appropriateness, satisfaction, and fidelity. This administrative supplement appropriately expands the scope of the parent award and will directly inform a future R01 clinical trial study to test the efficacy of the eHealth enhanced navigation intervention for improving uptake of substance use treatment and HIV prevention services for SGMYA impacted by the CS.

项目概要/摘要 综合物质使用障碍 (SUD) 和 HIV 的研究有强有力的科学前提 对监狱系统（CS）监控的个人进行预防干预。 SUD 导致发生率增加 CS 的参与以及艾滋病毒感染风险的增加。涉及 CS 的比例估计 患有 SUD 的人口达到 72%，每年约有 150,000 名艾滋病毒感染者进入拘留设施。 自我报告的性或性别少数群体 (SGM) 身份的个人在 CS 中所占比例过高，并且 经历了既定的艾滋病毒和药物使用不平等。尽管暴露前预防（PrEP）是一种 经证明有效的艾滋病毒预防干预措施，其最大影响取决于人们的吸收和坚持 那些高风险的人。迄今为止，很少有已发表的研究探讨药物滥用治疗和艾滋病毒预防 CS 相关人群（包括 SGM 成年人）的吸收情况。同行主导的导航干预措施 在建立信任和减少医疗保健参与障碍方面表现出功效，并具有强大的潜力 解决由 SGMYA 监测的治疗和艾滋病毒预防联系中的多重复杂障碍 CS。 SUD 和艾滋病毒预防的电子卫生保健方法也有希望，因为它们可以改善获得有效治疗的机会 干预服务，特别是针对SGM团体和年轻人的干预服务。作为一个拥有专业知识的多学科团队 行为健康（药物使用、心理健康、艾滋病毒预防）、成人 SGM 和 CS 以及电子健康 增强和导航员主导的行为健康干预措施，我们建议解决文献中的显着差距 通过扩大我们家长奖的目标来检验电子医疗增强的可行性和可接受性 由导航员主导的 SUD 和 HIV 预防转诊以及由 CS 监督的 SGMYA 的联动干预。学习 目标是： 1) 定制电子卫生技术支持的导航干预的内容和结构 满足 SGMYA（18 至 29 岁）独特需求的药物滥用治疗和 HIV 预防 (PrEP) 服务 由CS监督； 2) 完善和测试定制的电子健康增强型、导航员主导的药物使用治疗 由 CS 监督的 SGMYA 的 HIV 预防 (PrEP) 干预措施的适当性、满意度和 保真度。此次行政补充适当扩大了家长奖励范围，将直接 为未来的 R01 临床试验研究提供信息，以测试电子医疗增强导航干预的功效 提高受 CS 影响的 SGMYA 药物滥用治疗和艾滋病毒预防服务的采用率。